Neck lumps: causes and symptoms

There are many different types of neck lump, each with its own cause and its own likely path. Most are harmless and settle on their own; a smaller number need follow-up testing or treatment. Either way, getting an accurate diagnosis is what turns a vague worry into a clear answer, and many of the most common causes can be diagnosed with a safe, non-invasive ultrasound.

01Why neck lumps happen

The most common cause by far is an enlarged or swollen lymph node, lymph nodes contain cells that help your body fight infection, and they can grow when you become unwell. Ear and sinus infections, dental problems, strep throat and tonsillitis are all common triggers. Less often, a neck lump can be caused by a condition affecting the thyroid gland, an autoimmune disease, an injury to the neck muscles, or, occasionally: cancer.

Most neck lumps are simply a lymph node doing its job. The scan tells us quickly whether that is all it is.

Dr Husam Wassati, consultant head & neck and neuroradiologist

02Common, usually harmless causes

• Swollen lymph nodes, generally become noticeable once they reach 1 to 2cm, and can be painless or tender depending on the cause.
• Tonsillitis, a bacterial or viral infection of the tonsils, usually with a sore throat, fever and difficulty swallowing.
• Infectious mononucleosis (glandular fever), caused by the Epstein-Barr virus, typically in teenagers and young adults, with fatigue and swollen glands that can last for weeks.
• Lipoma, a slow-growing, soft, easily movable fatty lump. Usually harmless and painless.
• Thyroid nodules, lumps within the thyroid gland itself, solid or fluid-filled. Most are not a cause for concern.
• Goitre, a generalised enlargement of the thyroid gland, which can be harmless or linked to a change in thyroid hormone levels.

03Less common causes worth ruling out

A smaller number of neck lumps are caused by something that needs closer attention, which is exactly why an accurate diagnosis matters, not because these are common findings.

• Hodgkin and non-Hodgkin lymphoma: cancers of the lymphatic system, usually with swollen lymph nodes alongside fever, fatigue or unexplained weight loss.
• Squamous cell carcinoma: the second most frequently diagnosed skin cancer, appearing as a raised bump that grows over time and may not heal readily.
• Thyroid cancer: a rare cancer of the thyroid gland, accounting for less than 1% of UK cancer diagnoses.
• Throat cancer: an umbrella term for cancers of the vocal cords, voice box, tonsils and throat, more common in people with a history of heavy alcohol use or smoking.

04How ultrasound helps

A neck ultrasound is usually the first diagnostic tool used to work out what a lump is. By capturing detailed images of the lump and the structures around it, it can characterise swollen lymph nodes, blood vessels, salivary glands and thyroid nodules, and often provides enough information for an accurate diagnosis on its own. In some cases, a neck scan alone cannot fully determine whether a lump is cancerous, and your specialist will discuss further tests if that applies to you.

05What to expect from your ultrasound

A neck ultrasound is fast, non-invasive and carries no radiation. There is no special preparation and no downtime.

1. 1

   Before the scan

   You will be asked to remove anything covering your neck and throat, scarves and necklaces included.

2. 2

   During the scan

   You lie on the examination table with your throat exposed. A cool gel is applied, and a handheld probe is gently pressed to your neck to capture images.

3. 3

   After the scan

   The gel is wiped away and you can return to your normal activities straight away.

06What happens next

If you have noticed a lump in your neck, book a scan rather than waiting to see if it goes away on its own. Most people leave reassured with a clear explanation of what they felt; if anything does need a closer look, your specialist arranges the next step from the same visit.